Tests before diagnosis
There's a range of tests you may need to confirm whether CLL is the right diagnosis and find out more about your condition.
Blood tests
Blood tests are done in a lab using a sample of blood taken from your arm. You may not have all of these tests – your hospital team or GP will explain which tests you need.
This measures the number of each type of cell in the blood: red cells, white cells and platelets. CLL may be picked up if you have an FBC for another health condition.
If an FBC shows that you might have CLL, you’ll need more specialist tests.
FBCs are also used to monitor CLL after diagnosis.
Immunophenotyping (also known as flow-cytometry) is a technique used to find out if you have CLL cells in your blood and if so, how many there are. It’s more sensitive than a full blood count, so even if there’s only a small number of CLL cells, it can still detect them.
You might also have a peripheral blood film test, where a doctor looks at your blood cells are looked at under a microscope. Because CLL cells look different from normal lymphocytes, this test can help to identify abnormal cells in your blood. If you have CLL, your doctor will also see more lymphocytes in the blood film than there should be.
You may have this test which examines immunoglobulins (antibodies) in your blood. Too many or not enough of any type of immunoglobulin can make it harder to fight off infections.
This test checks whether your immune system is mistakenly attacking your own red blood cells, causing anaemia, a lack of functioning red blood cells. Anaemia can make you feel tired and out of breath.
When you’re diagnosed, you should have blood tests to look for viruses including hepatitis B and C, HIV and CMV (cytomegalovirus) as this could affect any treatment you may have.
Lymph node biopsy
Most people with CLL won’t need this test because the condition can usually be diagnosed by looking at the blood. But if you’ve got swollen lymph nodes and your FBC is normal, you may need a lymph node biopsy to check if you have a different type of blood cancer.
A lymph node biopsy is minor surgical procedure where a small sample of tissue is taken from a lymph node and studied under a microscope to check for signs of disease. Sometimes the whole lymph node is removed. This is called an excision biopsy.
Understanding your diagnosis
Ask your doctor or nurse to write down your exact diagnosis and don't be afraid to ask questions about what your diagnosis means for you.
You can also order our free booklet about CLL.